The present invention, in some embodiments thereof, relates to a hand-held, and optionally manually-operated, device for irrigating-evacuating a body cavity and specifically, but not exclusively, to a manually operated pumps mechanism which can be used to remove secretions from a subglottic region of an intubated subject.
Intubation involves positioning of a tube, such as an endotracheal tube (ETT) or a tracheostomy tube through the trachea of a subject terminating at a position above the carina, anterior to a position between the second and fourth thoracic vertebrate.
Endotracheal intubation is used to mechanically ventilate the subject's lungs when normal breathing is not supported, or to apply anesthetic gases during surgical intervention.
Tracheostomy is an operative procedure that creates a surgical airway in, anterior to a position between the cervical trachea. The resulting stoma can serve independently as an airway or as a site for a tracheostomy tube to be inserted. This tube allows a person to breathe without the use of their nose or mouth, or being mechanically ventilated when hospitalized or in homecare environment.
In order to create enough air pressure to accomplish mechanical ventilation and to prevent escape of gases past the tube, the tubes are sealed against the trachea using, for example, an inflatable cuff.
The inflatable cuff is inflated so as to engage the wall of the trachea and thereby seal the trachea and prevent gases being introduced through the tracheal tube from simply leaking around the tube. While use of an inflatable cuff is important for operability of an ETT, it can also contribute to complications.
Intubated patients can develop pneumonia resulting from an infection of the lungs induced by contaminated, pooled secretions with digestive content bypassing the epiglottis. To overcome these risks, endotracheal and tracheostomy tubes which enable single lumen suction or double lumen irrigation and suction of such secretions have been developed. Single lumen suction tubes are limited in that the suction often causes direct suction to be exerted on the tracheal mucosa which may then result in damage to the mucosa. Double lumen tubes while being vastly superior in enabling clearance of secretions require the use of complicated and expensive irrigation pumps.
U.S. Pat. No. 4,457,747 discloses an exchange transfusion device with two coupled, automatically driven syringes, one in a blood withdrawal system and one in a fresh blood injection system. The coupling insures that the volume of blood removed from a baby in the withdrawal system will be simultaneously replaced by an equal volume of fresh blood from the injection system.
U.S. Pat. No. 4,909,783 discloses an apparatus for maintaining pressure in the eye cavity while simultaneously removing and replacing fluid therein. The apparatus includes two syringes connected via conduits with hollow needles for insertion through a surface of the eye. One of the syringes is adapted to discharge a fluid and the other adapted to draw in a fluid. The Apparatus also includes drive means which displace the plungers of the syringes in opposite directions, whereby equal volumes of fluid are drawn in and discharged to the eye.
U.S. Pat. No. 5,957,883 discloses a synchronous vitreous lavage device for ophthalmology. The device includes a platform, a pair of main supporters, an auxiliary supporter, a pair of gears, a pair of movable seats, a pair of screw rods and a clamp for holding and controlling two lavage syringes. When the handle affixed to the gear is rotated by the turning of the hand, the first screw rod is rotated in one direction and the second screw rod is rotated in the opposite direction. The first movable seat and the second movable seat move in opposite directions. Then, one of the syringes absorbs the bloody water from the eyeball into it, and the other syringe simultaneously injects water into the eyeball. The absorption and injection of the two syringes are synchronously and isovolemicaly.
U.S. Published Application No. 20030069549 discloses a fluid exchange device which includes a first member connected to a piston that propels irrigant fluid and a second member connected to a piston that withdraws aspirant fluid. The members are in fluid communication with lumens that produce a closed loop with a target fluid exchange site within the body. The action of a trigger pulled toward a handle exerts a force on the irrigant piston that forces fluid through an irrigant lumen and simultaneously withdraws the aspirant piston to accomplish the fluid exchange at the target site.
International Publication No. WO1992007602 discloses an endotracheal tube having a double lumen sump action evacuating means associated therewith. The endotracheal tube includes a double lumen evacuating means, which is formed into the walls of the endotracheal tube. The evacuating means terminate at a suction eye positioned above an inflatable cuff for the endotracheal tube.